The Healing Power of the Will to Live

One way of understanding the underlying aspects of healing can come from an exploration of specific psychoanalytic concepts regarding the will to live and the will to die. Of particular relevance are the theories of Sigmund Freud, the founder of psychoanalysis, and the more current psychoanalytic theories of the British object relations theorists, especially Melanie Klein. The will to live is articulated psychoanalytically by the theory of Eros (life instinct) and the will to die by the theory of Thanatos (death instinct), both of which shed light on the process of healing. If one recognizes the mind/ body/spirit as whole and indivisible, then the significance of emotional factors in healing is clear. Healing is thus associated with integration and growth and the will to die with disintegration both emotionally and physically. The highlight of this work gives emphasis to the emotional aspects of the healing process.

This chapter explores the concepts of the life and death instincts first conceived by Freud, then further developed by Melanie Klein and her followers. Connections between these theories and the process of healing/integration are identified. An understanding of the early developmental stages of growth is also included, along with a description of factors that inhibit growth. The will to live is a powerful force that can overcome the sabotaging influence of the will to die. The life instinct is viewed as an impetus toward growth, ultimately leading to care and concern for the self as well as others. As such, it may also be seen as a spiritual force consistent with Judeo-Christian religious teachings.

Freudian Concepts of Eros and Thanatos

In the early twentieth century, Sigmund Freud, the founder of psychoanalysis, hypothesized two basic instincts inherent in the human condition: the life instinct (the will to live) and the death instinct (the will to die). Eros, the life instinct, includes the contrasting instincts of self-preservation (hunger instincts) and the preservation of the species (love instincts), both of which serve as unifying and binding forces. The life instincts are constructive and are directed toward progress and higher development. Civilization is basically the work of Eros libidinally binding humans to one another in an attempt to preserve life for the human species.

Sexuality, an important aspect of Eros, was initially viewed by Freud in the narrow, genital sense of the term but was later expanded to include bodily pleasure, which may or may not serve a reproductive function. Freud used the term libido to refer to the energy of the sexual or love instinct. The aim of the love instinct is to strive after objects and ultimately to preserve the species. Eros also includes the contrasting instincts of ego-love and object-love as Eros can be directed inwardly toward the self or outwardly toward others.

Thanatos (the death instinct) works in opposition to Eros and is a destructive force. It can operate internally and can be largely silently self-destructive, or it can be diverted outwardly and be destructive toward others. Freud posited that unexamined aggression is unhealthy and can lead to physical illness.

Initially, Freud viewed hate or aggressiveness as closely connected to the instinct of self-preservation and mastery. He viewed hate as older than love and stated that hate is a result of the “narcissistic ego’s primordial repudiation of the external world with its outpouring of stimuli.” He noted that the ego develops hate, pursuant to any object that is a source of unpleasurable feelings, and can result in aggressive and destructive inclinations toward the object. He later went on to hypothesize a separate death instinct that seeks to bring about death as a return to an earlier state of being. Aggression and cruelty toward others are now seen in a Freudian perspective as secondary and are derived from the death instinct, which is primarily self-destructive. Freud viewed the constancy principle, the tendency to reduce tension due to stimuli (also termed Nirvana), as a strong support for his hypothesis of the death instinct.

According to Freud, Eros and Thanatos are in constant conflict. However, the death instinct can be neutralized through its fusion with the life instinct. It can also be diverted toward external objects through the destructive or aggressive impulses, or a large extent of the death instinct may remain inside the individual, working in a silent, but self-destructive, manner. Eros attempts to render the death instinct innocuous by diverting the destructive-ness or aggression outwardly, where it may be viewed as destructive or as an instinct for mastery or the will to power.

In Civilization and Its Discontents, Freud theorized that the portion of the death instinct that was directed toward the external world could be used to service the life instinct because the individual would be destroying something animate or inanimate in the external world, rather than destroying itself. In other words, self-destruction would increase when there was a restriction of outward aggression. Freud viewed the inclination to aggression as the greatest threat to civilization. Thus civilization is built up at the sacrifice of the individual’s need to express his or her aggressive instincts and results in some unhappiness in the ego at having to sacrifice for the needs of society and in having some of the aggressiveness directed at the self.

Bruno Bettelheim, a psychoanalyst and one of Freud’s followers, argues that much of Freud’s theories are misunderstood due to mistranslation in the English versions of Freud’s writings. He states that the word instincts should be translated as impulses or drives. For example, we may say someone is driven by ambition or fear. Destructive or self-destructive actions may have been provoked by a mostly unconscious death drive or impulse. There is a constant internal struggle between the two contrary impulses, leading to suffering and conflict. As humans, we need to find a way to manage these inner contradictions.

Bettelheim agrees with Freud’s assumption that there are strong destructive impulses within our psyche (soul). Our task is to help the life drive from the potential damage of the darker, more destructive impulses. He advocates psychoanalysis as a way of gaining greater awareness of the darker aspects of life, which can help us to have love and concern, leading to a better life both for ourselves and future generations. Psychoanalysis is “an introspective psychology that tries to elucidate the darkest recesses of our soul—the forces least accessible to our observation.”

Eros, an equally powerful force within, assists us in making relationships better. Bettelheim sums up Freud’s view of the good life as being able to have positive, mutually gratifying, loving relationships and satisfying, meaningful work. This necessitates facing painful realities and difficulties, while maintaining a sense of optimism. Bettelheim ends his book with the following inspirational sentence: “We owe much to those before us and around us who created our humanity through the elevating insights and cultural achievements that are our pride, and make life worth all its pains; and we must recognize, with Freud, what those creators of our humanity did not deny but accepted and endured in the realization that only in conflict with itself can the human heart (as Faulkner said), or the human soul (as Freud would have said) attain what is best in life.” Thus, for Freud, the will to live is strong within us even as we struggle inside with the will to die. Healing comes from the life instinct, as we confront the darker aspects of life, modifying the potential destructiveness within and without.

Klein’s Contributions

Melanie Klein, a psychoanalyst following in the footsteps of Freud, used her clinical work and observations of children to understand and elucidate early emotional development. She became one of the leading British object relations theorists and therapists, helping us to understand the importance of psychic reality and the inner world, not just in childhood, but in adult life as well. In her work, she accepted and expanded Freud’s concepts of the life and death instincts, emphasizing the importance of our relations to objects (others).

From the time of birth, the infant experiences the internal conflict between the life instinct and the death instinct, in addition to experiencing the pains and pleasures of external reality. Much of emotional life can be seen as an interaction between self-preservation, pleasure, love, and hate. To live pleasurably and securely, one needs to manage the destructive forces within. Love is a manifestation of the integrating life force, while hate and cruelty emanate from the more destructive death instinct. Klein posited inherent life and death instincts that immediately give rise to conflicts. The death instinct creates a fear of annihilation and is experienced with anxiety by the infant. The destructive hating feelings are intolerable to the infant as they are felt to be a threat to existence and thus dangerous. He or she deals with these unbearable feelings by projecting aggression out onto an external object, initially, the mother.

The infant is relieved from the fear of annihilation from within but is now in the situation in which the outside world is experienced as dangerous. In particular, the mother is experienced as bad and threatening, resulting in feelings of persecutory anxiety on the part of the infant. The life instinct is also present, creating loving impulses and a need for self-preservation. The infant has an experience with a good mother that is infused with projected libido from the life instincts. The infant experiences gratification, as it feels pleasure and has its needs met. Early objects for the infant are experienced as part objects, which are split into good or bad, ideal or persecutory. The infant attempts to keep in or introject the good object and keep out or project the bad object. Splitting (keeping the good and bad apart) is used as a defense mechanism to keep the good objects safe from the destructive impulses of the death instinct.

Klein’s concept of splitting can be illustrated quite well by children’s literature and play. Superheroes are all good and all powerful and are in conflict with evil figures needing to be conquered. Children prefer endings where good triumphs over evil. There is a clear division between good and evil, with the good representing the loving impulses and the bad representing destructive impulses. Ron Britton, another Kleinian analyst, posits that the arts and literature are attempts to represent externally that which is profoundly internal.

It is interesting to note the constant interplay between internal forces and external reality. External reality, for the infant, is a mix of gratifying experiences, like the warmth, nurturing, and love from the mother, and painful, frustrating experiences of unmet needs. Internally, because of the need to deflect inner hatred and destructiveness, bad objects may be created even if not bad in and of themselves. Unfortunately for the child, a vicious circle may be created if the external environment contains a lack of love and understanding. This may accentuate his or her expectation of a bad world and increase his or her destructive impulses. Similarly, gratifying experiences facilitate the life instinct, fostering growth and integration, leading to a healthy desire to explore reality and further cognitive development.

At this time in the infant’s development, the infant perceives and relates to two part objects: the ideal, loving breast and the persecutory, frustrating breast. The infant’s wish is to keep the good inside and deflect the bad outside. Klein calls this phase of development the paranoid-schizoid position as it is characterized by splitting (schizoid) and by paranoid persecutory anxiety that is fearful of annihilation. Both loving and destructive impulses are projected and introjected to preserve the good from being destroyed by the bad. The infant’s fear of annihilation (from the death instinct) creates anxiety that is defended against by a projection into the external object, making it persecutory, and by aggression directed against this external object. A projection of the life instinct also occurs, resulting in an idealized external object.

At this point, the good and the bad are kept separate or split, and both self and object are split into good and bad parts. The good self and objects are separated from the bad to protect the good from the contamination of destructiveness. Fortunately, as the baby takes in nourishment and love, which support life, he or she takes in loving feelings of the life instinct, which are used to neutralize the destructiveness of the death instinct. As the baby introjects good experiences, he or she internalizes good internal objects, facilitating healthy development. As love predominates, persecutory anxiety decreases, and ego integration and synthesis increase. Positive stimuli in the infant’s environment reinforce trust, while negative environmental stimuli, such as lack of love and nurturance, reinforce splitting, disintegration, and persecutory anxiety. In addition, Klein noted that in some infants, aggression is innately strong, leading to difficulty tolerating frustration and anxiety. There is a constant interplay between environmental factors and constitutional factors in the emotional growth of the baby.

As the infant continues to develop normally, at about six months of age, he or she gradually enters what Klein termed the depressive position. The child begins to become aware that there are good aspects to the bad or frustrating objects, and bad aspects of the good or ideal objects, and that indeed, they are really one whole object with good and bad parts. The experience of love and hatred become closer together, resulting in feelings of ambivalence toward the mother and others important to the infant. As a good object becomes introjected, there is a feeling of a good internal object that reduces persecutory anxiety. The ego becomes more integrated and synthesized. The baby also becomes more aware and tolerant of his or her own aggressive impulses and has less need to project the bad outwardly.

Along with this process of decreasing projection and splitting, there is consequently less need to fear the persecution of others. The infant’s anxiety in the depressive position is no longer persecutory, but is of a fear of causing harm to his or her objects, upon which he or she pours love and depends. This creates feelings of depressive anxiety and guilt. “The depressive conflict is a constant struggle between the infant’s destructiveness and his love and reparative impulses. Failure of reparation leads to despair, its success to renewed hope.”

Normally, the infant is able to work through these feelings, and reality testing increases; that is, there is a better capacity to differentiate unrealistic phantasy (inner psychic reality) and external reality. There is an inhibition of aggressive impulses, and efforts at reparation are made when he or she experiences feelings of guilt for hurting his or her loved object. As this developmental process occurs, he or she becomes more aware of self as separate from love objects. The child feels concern for others and is aware of his or her own impulses of love and hate.

Klein called the paranoid schizoid and depressive processes positions, rather than stages, to emphasize that they both recur throughout life and that the anxieties associated with each position are never fully worked through. Initially, the baby alternates between experiences of disintegration and integration and then gradually develops more integration and a greater capacity to relate to a whole object or person toward whom he or she has ambivalent feelings. The healthy object relation is neither all bad (persecutory object) nor all good (idealized object), but rather is a whole, with both gratifying and frustrating aspects.

When development is healthy, the death instinct is in service of the life instinct, resulting in healthy aggression. If the death instinct is predominant, perversions may occur. It is hoped that the depressive position will have sufficient resolution and that the infant will have a strong capacity to retain good objects internally. The child will need these good internal objects to help him or her later, as he or she experiences the realities of life that always include situations of loss and feelings of anxieties related to guilt and ambivalence.

John Steiner emphasizes Klein’s view of normal splitting as important for healthy development. Splitting is a way of helping the infant organize the chaos of postnatal experience. If there are sufficient good experiences, the infant can grow in a healthy way, and splitting is decreased. When the environment does not provide sufficient nurturing, the infant’s persecutory anxieties and fear of annihilation are not allayed, and the splitting becomes pathological. In this situation, the infant relies on splitting as its main strategy for survival, and growth is impeded. In healthy development, integration of self and object occurs, and the infant’s focus is no longer on self-survival. Instead, he or she is able to tolerate his or her dependence on the object and have feelings of love and concern.

Envy was viewed by Klein as a derivative of the death instinct and as a hostile, life-destroying force. Along with the experience and recognition of needs, there is a painful awareness of dependence and a hatred of needy feelings and the needed good object. Envy is aroused by feelings of gratification experienced from the object and because of the goodness of the object. Awareness of separateness and the value of the object also stimulate envy. Envy begins as a destructive spoiling function, when it is realized that one cannot possess the needed other. The infant spoils the object to rid himself or herself of the painful, envious feelings. Unfortunately, envy hinders healthy development in light of the fact that when the good object is turned bad, there is no longer a good object to internalize. If the envy is not too powerful, it can become integrated, and healthy feelings of love and admiration will occur. Feelings of gratitude can overcome and modify feelings of envy.

One of Klein’s major theoretical contributions was her understanding of manic defenses. As the infant develops, he or she experiences painful feelings of dependence on a valued object (mother), ambivalence, fear of loss, separation, and guilt. Manic defenses are erected to protect the ego from psychic pain and feelings of despair. They are used as a way to defend against the reality of the vulnerability of the human experience, including the limitations of the self and others. When manic defenses are operating, objects are treated with feelings of contempt, control, and triumph. The object is devalued, controlled, defeated, and attacked, eliminating the need for painful feelings of dependence, loss, concern, and guilt.

Herbert Rosenfeld, one of Klein’s followers, expanded on Klein’s theories by exploring the destructive aspects of narcissistic object relationships and the importance of understanding these dynamics in psychoanalysis. He describes the prominent role that omnipotence plays in narcissistic object relations and states that objects are treated as the baby’s possession and are used as containers for undesirable parts of the self to rid the self of pain and anxiety. Defenses are used to avoid any recognition of separateness between self and object to avoid painful feelings of dependence and the anxieties that result from the inevitable frustrations inherent in a dependent relationship. By omnipotently identifying with the object, the narcissist avoids the painful awareness of envy and the aggressive feelings caused by the frustrations associated with dependence on an object.

Rosenfeld goes on to say that in severe narcissistic disorders, rigid defenses are erected against any awareness of psychic reality. In these disorders, the anxiety that results from any conflicts between parts of the self or between the self and reality is intolerable and thus evacuated into the object. In analysis, the patient desires a lavatory mother, into whom he or she can discharge everything unpleasant and relieve himself or herself. Progress in the analysis is made only when the patient is able to acknowledge the feeding function of the analyst, to recognize the analyst as separate, and to accept the attendant depressive anxieties and frustrations.

In a later paper, Rosenfeld further elaborates this process by saying that the narcissistic patient would like to believe that he or she has given life to himself or herself, and can certainly look after self, not needing anyone. He or she reacts destructively to evidence that he or she is dependent on the analyst and may act out in self-destructive ways. This dynamic parallels how the young child was unable to accept dependency on the mother earlier in life. At times, these patients may devalue the analyst’s work. “In this way they assert their superiority over the analyst representing life and creativity by wasting or destroying his work, understanding, and satisfaction. They feel superior in being able to control and withhold those parts of themselves which want to depend on the analyst as a helpful person.” The conflict between the destructive and libidinal parts is resolved by getting rid of the loving, dependent part of the self, being left with only the destructive, narcissistic part. The patient is then able to feel superior and avoid the envy, conflict, and anxieties that accompany awareness of the dependent self.

Rosenfeld also links the destructive, narcissistic parts of self, in some cases, to psychotic structures or organizations that are split off from the rest of the personality. This psychotic structure may be dominated by an omnipotent notion that there can be complete painlessness within the delusional object, which may provide the patient with a false sense of security by promising quick, painless solutions to all conflicts and problems. Clearly this is quite seductive and can lure any sane parts into the delusional structure. This part of the personality perceives progress as quite dangerous, which may lead to a severe negative therapeutic reaction.

When this occurs, the patient may lose contact with his or her capacity for thinking and sense of reality. The patient may withdraw from the world and often feels drugged. This may be accompanied by a desire to stay in bed, missed sessions, and complaints of feeling trapped and claustrophobic. When this occurs, the sane, dependent part of the self has become completely dominated by the destructive, omnipotent, narcissistic self and must be recovered through analysis.

The analyst must also work to uncover and expose the destructive, omnipotent parts of the self. “In other words, the patient becomes gradually aware that he is dominated by an omnipotent infantile part of himself which not only pulls him away towards death but infantilizes him and prevents him from growing up, by keeping him away from objects who could help him to achieve growth and development.”

Rosenfeld also discusses a clinical approach to the theory of the life and death instincts, describing the difference between the libidinal and destructive aspects of narcissism. According to Rosenfeld, the violence of the destructive impulses can vary from person to person and can oscillate within the same individual. In other words, there may be times when the libidinal, life-generating aspects predominate, and other times when the destructive aspects are dominant. When the libidinal aspects are dominant, the person is able to recognize the separateness and the value of a needed object—the analyst, for example—and to experience conscious envy of the object’s good qualities.

In contrast, there are times when the destructive aspects are dominant and manifest as a wish to destroy the object as the source of goodness, and also destroy the self. There may be a wish to die, and death may be viewed as a solution to the problems of life. The most dangerous situation is that in which there is a severe split, making the destructive aspects completely defused from the libidinal, caring self. So the life instinct allows the individual to be in contact with a loving self who needs and is concerned for others, while the destructiveness of the death instinct despises this loving, dependent self and attempts to eliminate these feelings.

Instead, the destructive self retreats into narcissism, admiring the self, devaluing others, and feeling superior. There is a sense of self-sufficiency and a denial of need for relationships with others. Clearly this interferes with healthy development since it prevents the person from turning to others, who could help him grow. A positive, libidinal, dependent self is important in establishing healthy object relations and neutralizing the destructive narcissism.

Hanna Segal and David Bell indicate that narcissistic object relations are a result of splitting of good and bad objects internally and are characteristic of the paranoid/schizoid position. The aim is to protect the good self and objects from the murderous objects that contain the split-off aggression. Like Rosenfeld, they indicate that the person with narcissistic object relations is not able to bear the anxieties of the depressive position, which include anxieties about separation, the fear of loss, and the guilt and concern about damaging good objects. The person is also not able to bear the envy that comes with recognizing the goodness of the object.

As these anxieties become more tolerable, the person will develop a greater capacity for differentiating self and object and a firmer relation to internal and external reality. The person with narcissistic object relations uses projective identification to omnipotently deny and project aspects of the self. The object then becomes identified with those projected aspects, and its real properties are obscured. Narcissistic patients are thought to be equally prone either to idealize or denigrate their objects and have a profound incapacity to see objects as they really are.

According to Segal and Bell, the ego of the narcissistic person is weakened through the excessive use of denial and projection. He or she can also be quite paranoid and become preoccupied with the state of his or her objects. In analysis, he or she may be quite attentive in terms of what the analyst’s interpretations suggest about the state of mind of the analyst. Klein’s 1946 paper is cited, in which she referred to schizoid object relations, which is the term used by Klein for these clinical phenomena. In this paper, Klein aptly described the relationships of these patients to be either detached, due to the fear of the objects, felt to contain the terrifying projected aspects of themselves, or to be clinging and compulsive, due to a fear that losing the object means the annihilation of parts of themselves.

Segal and Bell also explain the role of envy in narcissistic disorders. Since the narcissist hates the very goodness of his or her objects, he or she is unable to acknowledge the objects’ worth and separateness, and thus enviously attacks and devalues them. The child then feels persecuted because he or she has turned the objects into persecutors through the process of projection. Segal and Bell believe that ultimately, more normal object relations can only be achieved when the depressive position has been established. It is only in this position that there is a differentiation of self from object. This allows the object to be out of the subject’s control and allows the person to negotiate the oedipal conflicts of the object’s relations to other objects.

To grow and develop, there needs to be a sane awareness of the need for nourishment and dependence on an external object that is not under the control of the self. The narcissistic aspects of the person violently object to this reality, preferring to exist in a superior state of narcissistic self-sufficiency. There may become a hatred of life and an idealization of death, which is then viewed as a state in which the patient is free of need and frustration. The life and death instincts are seen as in constant conflict with the feelings of love and gratitude being pitted against feelings of hatred and envy.

Emotional Healing and Integration

In the context of this chapter, emotional healing is conceptualized as emotional growth and development, leading to a healthier state of mind. Although beyond the scope of this chapter, it is generally well accepted that psychological health also improves physical health and well-being. One avenue of potential healing comes from psychoanalysis, which, if successful, results in increased psychological integration and psychic change. Previously split off or repressed feelings may be experienced; relationships are more valued, and people are seen as separate, more whole people, toward whom we have ambivalent feelings. The individual grows in his or her capacity to take responsibility for loving and hating impulses, consistent with the Klein’s depressive position. As Betty Joseph, another Kleinian analyst, states, “It means developing beyond feelings of omnipotence and narcissistic illusions into a world of real people, towards whom guilt and loss can be experienced and overcome and inner confidence built up.” These are several of the kinds of changes that are seen as desirable for a healthier life.

In psychoanalysis, the analyst observes and interprets the shifts between the anxieties and defenses of the paranoid-schizoid position and the anxieties and defenses of the depressive position. These processes, previously unknown and unconscious to the patient, become conscious with the help of the analyst. The strengthening of the ego and the insight gained in analysis help the individual to work through conflicts, as opposed to denial or acting out. The analysis, over time, gradually leads to a decrease in splitting, allowing an internalization of a good object. “This mitigates the destructive-ness of the early superego, helps the integration of the ego, and increases its strength.” This process parallels the growth of the child in early development, as there is a gradual withdrawal of projections and a more integrated self and object.

Segal views narcissism as a result of envy and the death instincts, which attack healthy self-love and the life-giving relationships of others. In contrast, the life instinct creates the capacity to love the self, while at the same time loving others. In other words, self-love is not at the expense of others, nor is the love of others at the expense of the self. Analysis supports the life instinct, helping one tolerate feelings of dependency and love of the needed other.

In addition, there is a greater self-love and inner confidence of the good inside. Growth occurs as the patient acknowledges the internal conflict of the constructive and destructive impulses, including unwanted feelings of neediness, envy, and aggression. The patient begins to understand that his or her feelings are rooted in the inherent frustrations of the early maternal relationship and is able to take responsibility for his or her feelings and actions. Greater understanding and insight lead to a stronger capacity for integration, love, and gratitude. There is a hope that loving impulses and the will to live predominates over hatred and the destructive impulses.

Catalina Bronstein, in her book on Kleinian theory, reiterates Klein’s emphasis on the importance of the integration of the destructive impulses with the more benign impulses.27 In clinical work, this may be seen as the patient develops a less severe superego (conscience) and a greater capacity for repairing the damage done to his or her objects. The patient also feels more trust in his or her inner goodness, a stronger capacity to tolerate anxiety, more feelings of love and peace, and consequently, improved relationships with others.

These ideas pertaining to the healing power of the will to live hopefully overcoming the inner destructive impulses (the will to die) are viewed as quite consistent with Judeo-Christian teachings. Mature religions view envy and omnipotence (pride) as destructive (evil), having negative consequences. Redemption and reparation are needed to repair the damage done to humankind. Spiritual healing is needed to transform the destructiveness into constructiveness.

Neville Symington makes a distinction between primitive religions, which are more concerned with external appearances and placative acts, and mature religions, which have as their aim an actual transformation of the mind and the heart. “Mature religion is concerned with how we should live and act toward our neighbor and toward ourselves.” Amos and Isaiah, Jewish prophets in the Old Testament, and Jesus of the New Testament proclaimed this as their central message. Transformation of the heart, leading to acts of goodness, social justice, and helping the oppressed, are valued over external rituals and sacrifices.

Symington views this goal of transformation as a shared goal of psychoanalysis and mature religion. The self-knowledge gained from psychoanalysis is viewed as inseparable from acts of virtue, particularly as one relates emotionally to others in close relationships. In psychoanalysis, this transformation occurs as a natural result of increased integration and decreased narcissism and omnipotence. In the Christian faith, compassion for others is one of the fruits of the divine spirit in us.